It is well-established that abuse, neglect, and exploitation, referred to as adult maltreatment in this funding opportunity announcement (FOA), can have grave consequences, including increased mortality, increases in occurrence and severity of chronic diseases, and the loss of savings and even homes. Responding to adult maltreatment generally falls under the purview of Adult Protective Services (APS) programs. These programs are state-established and administered, authorized by state law, and primarily state-funded. As authorized by state statutes and regulations, state and local APS agency programs receive and respond to reports of adult maltreatment.
The Elder Justice Act (EJA) was first introduced in 2002 and enacted into law in 2010 as part of the Social Security Act. Within the EJA are a number of grant programs to protect older people, including a grant program to support states by bolstering the activities of state Adult Protective Services programs. These grants are authorized by Section 2042(c)(1) and (3) of Title XX of the Social Security Act, Subtitle B, the Elder Justice Act of 2009 (EJA):
‘‘(c) STATE DEMONSTRATION PROGRAMS.—
‘‘(1) ESTABLISHMENT.—The Secretary shall award grants to States for the purposes of conducting demonstration programs in accordance with paragraph (2).”
‘‘(3) APPLICATION.—To be eligible to receive a grant under this subsection, a State shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.”
Along with the enactment of the EJA, ACL has implemented a number of efforts to meet the goals and objectives of the EJA. In FY 2013, the Administration for Community Living (ACL) began efforts to address the challenges related to APS data collection. In partnership with the HHS Assistant Secretary for Planning and Evaluation, ACL developed a pilot system to demonstrate the data standards and technology infrastructure required to support a voluntary, national APS data collection system, the National Adult Maltreatment Reporting System (NAMRS). In FY 2015, ACL launched the implementation phase for NAMRS.
NAMRS is designed as a voluntary data collection tool that enables states to report data gathered through APS investigations. The goal of NAMRS is to provide consistent, accurate national data on adult maltreatment, as reported to state APS agencies. The design of NAMRS has been informed by multiple stakeholder focus-groups and several meetings with state representatives. In 2017, the first year of operation, 54 of 56 states and territories contributed data to NAMRS. This high level of voluntary participation reflects the value that leaders in the field of adult protective services see in this data. In 2018, all 56 states and territories contributed data to NAMRS. Full implementation of NAMRS will include the 50 states, the District of Columbia, and Puerto Rico reporting on all data elements on an annual basis to ACL. For more information about NAMRS, please visit the NAMRS webpage on ACL’s website.
FY 2015 marked the first year ACL received a dedicated appropriation to support states in enhancing their APS systems statewide, and awarded grants under Section 2042 for the EJA. Through FY 2018, ACL continued to receive appropriations for states and make such grants to improve APS practice, services, data collection, and reporting; and to support states’ participation in NAMRS. Previous state grantees’ activities have focused on building the necessary inputs and resources to conduct the work of their APS state systems, including:
Developing and implementing training curricula for APS staff,
Building community partnerships,
Engaging consultative experts,
Creating new, or enhancing existing, operational supports such as electronic case management systems,
Creating and validating risk and safety assessment tools, and
Increasing the quality and quantity of data reported to NAMRS.
In September of 2016, ACL also published the National Voluntary Consensus Guidelines for State Adult Protective Services Systems (Guidelines). The purpose of the Guidelines is to promote an effective APS response across the country so that older adults and adults with disabilities, regardless of the state or jurisdiction in which they live, have similar protections and service delivery from APS systems. The Guidelines are intended to assist states in developing efficient and effective APS systems. Overall, the Guidelines are designed to provide APS Administrators with recommendations from the field about quality practice. There are several ways that states may choose to utilize the Guidelines, including as a model of comparison to existing APS systems offered, to identify new areas of interest, or to identify areas for improvement in current state statutes or policies.
The purpose of ACL’s “Grants to Enhance State Adult Protective Services ” is to strengthen and enhance state APS systems. This funding opportunity promotes innovations and improvements in state APS practices, services, and data collection that are consistent with ACL’s mission and incorporate a consumer-directed approach. That is, APS practice holds autonomy, self-determination, and self-direction as fundamental values, and APS interventions are rooted in people’s strengths, assets, goals, culture, wishes, and expectations. With this funding, states are expected to review the capacity of their current state APS information systems and determine how they can improve the quality and quantity of data reported to NAMRS.
Applications are sought from the state government offices that administer the state’s adult protective services and/or elder protective services program. Former and current APS Enhancement grantees ARE eligible to apply. Please note that funds awarded under this opportunity cannot be used to continue or carry out the same activities as under previous grants. Former and current grantees who apply must propose new activities that are unique and distinct from past activities and that are consistent with the guidelines provided in this funding opportunity. In an effort to expand the reach of these grants, applications from states who have not received a grant under this opportunity in previous years will receive an additional 10 points on their review score.
For this opportunity, ACL invites applications that seek to achieve:
Improvements in the state’s infrastructure for providing APS services, and improvements in the APS intake, investigation, post-investigation, and quality assurance processes, and
Improvements in the state's ability to document and report APS case, client, and perpetrator characteristics and services in a manner that is consistent with the National Adult Maltreatment Reporting System (NAMRS).
Below are the areas of activities applicants should consider to undertake with this funding. Within these areas, ACL encourages states to think creatively about how they would strengthen their systems to meet the goals of this funding opportunity:
1. Efforts to use technology and data to:
Expand the state APS program’s participation in NAMRS data collection
Improve the quality of data collection by local APS agencies and their ability to report reliable and valid data to the state APS office
Improve the state APS program’s ability to track APS reports, investigations, services, resolution, and outcomes of adult maltreatment reports and cases
Use data for state and local APS program quality assurance
2. Efforts to improve the state’s APS intake, assessment, screening, and investigation of reports of adult maltreatment, such as to:
Implement existing valid and reliable tools for client assessment (e.g., risk, safety, decisional ability),
Improve rates of consistency in APS practice across the state
3. While protecting individual privacy, autonomy, and self-determination, efforts to increase multidisciplinary collaboration between the state’s adult protective system and other systems with key roles in preventing and addressing adult maltreatment to:
Enhance investigations of and responses to adult maltreatment
Develop, support, or strengthen interagency collaboration and communication
Map available services for victims, identify service gaps and needs, and develop protocols for coordination of services
4. Efforts to implement and test new client interventions or services (offered by APS alone, or in partnership with others), such as:
Family systems interventions, such as restorative justice models and other non-criminal interventions
New services for clients such as emergency housing, psychotherapy for victims, hotlines, etc.
5. Creating new, or improve upon existing, state and local APS policies and protocols to:
Respond to community or public health emergencies, such as natural disasters
Ensure APS worker safety
Improve public education relating to the role and responsibilities of the adult protective services program
Move the state's APS system to more congruence with the National Voluntary Consensus Guidelines for APS Systems
6. Efforts to increase intra- and inter-state sharing of information on APS cases to:
Facilitate and improve inter- and intrastate information exchange about adult maltreatment with other state APS programs and/or with law enforcement
Implement agreements between states and tribal government entities to improve APS intake, assessment, screening, and investigation of reports of adult maltreatment in those states serving tribes
7. Efforts to improve APS worker and supervisor performance by implementing evidence-based training curricula on specific:
Areas of knowledge needed by APS workers or supervisors
Skills needed by APS workers or supervisors
Abilities needed by APS workers or supervisors
Proposals should clearly state the change they are seeking through this funding opportunity, the objectives they will strive for to meet those goals, and the activities they will undertake to accomplish their identified objectives. In the project narrative, all applicants should detail how they plan to address the following (complete instructions on writing the project narrative can be found in Section IV.2):
Status of the current state APS system and challenges that need to be addressed
Goals for an improved state/local APS system
What activities are proposed to reach those goals
Justification for the selected activities
How the proposed activities will be carried out
How the proposed activities improve a state’s current APS practice, and move the state closer to its goals
How the applicant will improve the quantity and quality of NAMRS data elements the state reports
How the state will sustain the APS enhancements after grant funding.
Applicants may use a logic model in organizing their proposal. A sample logic model is included in Section VIII.1.2. The logic model is not a requirement for application; does not substitute for the required, written application narrative; and no additional points will be awarded based on whether a logic model is included or not. The logic model is provided as a tool to help applicants organize planning. As a condition of award, new grantees will be asked to complete a logic model of their project within the 1st six months of the project. However, the presence or absence of a logic model with or in the application will have no effect on scores.
The project period is three (3) years, depending on satisfactory performance, the availability of funds, and the determination that the program is still in the best interest of the government. Over the three years, ACL anticipates the grantees generally will follow the timeline below. This is only a sample timeline. Actual planning, implementation, and wrap-up activities will vary for each proposal. This sample timeline is provided to help applicants think through the different phases of project planning:
Planning (Months 1-6)
Attend grantee meeting convened by ACL (target 1st week November 2019)(1);
Participate in project officer technical assistance meetings;
Refine and finalize project plan, outcomes, and sustainability goals;
Assess current NAMRS reporting to target for improved quality and quantity(2);
Launch project activities.
Implementation (Months 7-33)
Track performance, outcomes, and sustainability planning;
Submit semi-annual reports;
Participate in project officer technical assistance meetings;
Attend annual grantee meeting convened by ACL (Target: September 2020; September 2021)(1)
Final Phase (Months 34-36)
Enter project final phase;
Transition to sustainability plan;
Participate in project officer technical assistance meetings;
Prepare project data for final reporting.
(1) Grantee Meetings
ACL plans to convene an “all grantee meeting” within the 1st quarter of each project year. Grantees are encouraged to attend these meetings, and grant funds may be used to cover this grant-related expense. If applicants intend to use grant funds to attend this meeting, they should include this expense in the application budget.
(2) NAMRS Reporting
Currently, all states report some data to NAMRS. All grantees of this funding opportunity will be required to continue participation in NAMRS during the grant period. During the grant, ACL will provide technical assistance to grantee states on NAMRS activities. Proposals should identify either an increase in the quantity or the quality of data elements the state is reporting (or both). Applicants should consider the level of effort they foresee for improving their NAMRS reporting, and include the effort in the project narrative, the work plan, and the budget, and any other application documents as appropriate.
Technical assistance to the grantees will be provided primarily by ACL program staff via regular conference calls, email correspondence, webinars, and annual grantee meetings, and by ACL’s National APS Technical Assistance Resource Center (operated under a separate contract).
Grantee evaluations of their projects facilitate the government in assessing whether programs are effective in producing positive change. Grantees will be asked to include progress and information/data on the project’s outcomes and the evaluation in semi-annual reports and at other times as agreed upon by the grantee and ACL.
For this opportunity, applicants are asked to include a description of the method/s that will be employed to successfully measure whether or not the project has achieved its proposed outcome(s) and the overall goal for this funding opportunity, and who will be responsible for carrying out the evaluation activities. This evaluation plan should be included in the “Evaluation” section of the application narrative.
The qualifications of the evaluator will be reviewed in the section of the project narrative for “key personnel.” Although ACL will provide technical assistance to grantees with the refinement of a project’s evaluation plan, applicants should identify in their applications an individual responsible for the evaluation. If an evaluation will be obtained after the grant is awarded, applications should identify the evaluator skills they will seek out, as well as the method for acquiring the evaluator. Applicants should consider the associated time and costs for evaluation within both the work plan and their application budget.
Rights in Data
The following describes the HHS policies around "rights in data." These are included by reference in the conditions of the Notice of Award.
ACL understands that the outcomes and results from these demonstration grants may be such that the awardee would like to publish an article or report on the project’s results, or disseminate information in some other public way. Per the HHS Grants Policy Statement (January 1, 2007), page II-69: “In general, [grant] recipients own the rights in data resulting from a grant-supported project or program….[A]ny publications, data, or other copyrightable works developed under an HHS grant may be copyrighted without OPDIV prior approval.” That is, grantees under this funding opportunity do not need ACL approval to publish reports, articles, or other material about their projects. However, any published reports, articles, or other material must include the following disclaimer:
"This (activity/report/document/etc.) was supported, in part, by a grant (No. XX-xxxx) from the Administration for Community Living, U.S. Department of Health and Human Services (DHHS). Grantees carrying out projects under government sponsorship are encouraged to express freely their findings and conclusions. Therefore, points of view or opinions do not necessarily represent official Administration for Community Living or DHHS policy."
Applicants should also note that Under 45 CFR §75, ACL reserves a royalty-free, nonexclusive, and irrevocable right to reproduce, publish, or otherwise use copyrightable works developed (or for which ownership was purchased) under this cooperative agreement for Federal purposes, and to authorize others to do so. The Federal government's right to such copyrightable works and data are explained further in the HHS Grants Policy Statement. For this funding opportunity, this means that grantees may not withhold from ACL data or information produced from or by this project, including, but not limited to, outcome and evaluation data. Per the Terms and Conditions included in the Notice of Award for this funding opportunity, grant recipients must provide a final report at the conclusion of the project that includes the data and materials produced by the grant.
Please Note: The HHS Grants Policy Statement defines “data” as “recorded information, regardless of the form or media on which it may be recorded, and includes writings, films, sound recordings, pictorial reproductions, drawings, designs or other graphic representations, procedural manuals, forms, diagrams, work flow charts, equipment descriptions, data files, data processing or computer programs (software), statistical records, and other research data.”